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OPIATESWhat Is The REAL Problem?
Is There A Solution?
Russell Ferstandig, M.D.Medical Director and Founder
Monmouth Behavioral Medicine Center
Manasquan, New Jerseymonmouthbehavioralmedicine.com
[email protected] 732-477-4470
Why You Should Listen To MePsychiatrist For 35 Years
Addiction Specialist For 30 Years
Board Certified In Addiction Medicine (American Board Of Addiction Medicine)
Suboxone® Provider For 9 Years With 100’s of Successes
Recovered Cocaine Addict So I Have Lived The Life Of Addiction
THIS PRESENTATION IS
ABOUT HOPE BECAUSE
THERE IS A GUARANTEED
SOLUTION FOR ANYONE
ADDICTED TO OPIATES!!!!
In Order To Find An
Opiate Solution,
You Need To
Understand The
Opiate Problem
The ProblemThe problem has two components:
Lifestyle – People feel the need to hide in
unreality because reality is uncomfortable.
Physiologic – Opiates Addict Everyone
The ProblemLifestyle Component No simple solution
Based on unrealistic goals and
expectations about life
Young people feel inadequate
A search to feel better – NOW
The Basic Rule Of
Human BehaviorPeople will resist change by maintaining their
current behavior until:
The perceived cost of maintaining the
behavior exceeds the perceived cost of
changing the behavior
The perceived benefit from change greatly
exceeds the trouble (real and imagined)
generated by the change process.
The Basic Rule Of
Human BehaviorSimplified
People will change
when it hurts too
much not to change.
The ProblemOpiate Physiology – No one is
protected from opiate addiction.
The ProblemOpiate Physiology – No one is
protected from opiate addiction.
The ProblemThe Brain Does Not Like
External Opiates Of Any Sort
Heroin
Opiates (Pills)
Opioids (Opiate-Like Substances)
Natural Opium
The Brain’s Natural Opiate
System Is Disrupted By
External Opiates Of Any Type Natural opiates (endorphins) are secreted in very small
amounts, probably less than 1/1000th% (0.001%) of
external opiates AND only for seconds or a minute or two
External opiates are present in progressively large
doses for hours, days, months or years
The Combination Of Excessive Opiates For
Long Durations Forces The Brain To ADAPT
To Keep The Individual Alive
The Stronger The Opiate,
The Faster The Individual
Becomes Addicted, Their
Brain Adapts To The
External Opiate And
Becomes
NJ Heroin Is One Of The
Strongest Opiates Available
NJ Heroin Cut With Fentanyl (Bud Light)
Is The Strongest Opiate Available
Opiates And Opiate
Withdrawal
One of the biggest causes of
opiate relapse is
that promotes and justifies repeat opiate use
occurs while using opiates AND/OR when withdrawing from opiates
Opiates And Opiate
Withdrawal
Therefore, the only way to avoid “opiate
logic” and opiate behaviors is:
100% abstaining from opiate use
AND
100% stop of withdrawal symptoms
24/7 till the brain is 100% healed
The SolutionThere Are Four Necessary
Steps To Produce A Lasting
Solution –
The Four Steps To
Becoming Opiate Free1. Individual must be truly ready to stop using
opiates (“should stop without commitment” almost never works)
2. Withdrawal must be stopped 100% 24/7 until the brain has 100% healed (returned to the pre-opiate state. Said another way – the opiate altered state TOTALLY reversed)
The Four Steps To
Becoming Opiate Free
3. Identify and correct all psychiatric problems
that are likely triggers for relapse (anxiety,
depression, ADD, etc.)
4. Therapy to better identify triggers, modify opiate
thinking distortions and learning new coping skills
The Four Steps To
Becoming Opiate FreeAll Four Steps Are Required For
Lasting Success
1. Committed to stop
2. 100% Removal of withdrawal symptoms till
brain 100% recovered
3. Correct psychiatric triggers
4. Therapy for better life coping skills
The Four Steps To
Becoming Opiate FreeSummary
Four Necessary Steps
OptionsThere Are Many Options To Treatment Design
Choose The Design That Works Best For You
There Are No Shortcuts
Shortcuts Essentially Guarantee Relapse
Common Shortcuts That Produce Relapse
Individual Not Ready To Stop Using Opiates
Withdrawal NOT Stopped 100% Until The
Brain Has 100% Healed (Returned To The
Pre-opiate State)
How To Feel Good And Be
Productive During Recovery
From Opiate Use And Abuse
It is impossible to feel good and be
productive during active opiate use
and/or withdrawal
The Only Solution Is 100%
Elimination Of WithdrawalCurrently there are only two ways to eliminate withdrawal symptoms totally:
Suboxone® treatment using the required medication techniques AND proper doses during all phases of treatment, especially the taper phase
Methadone maintenance, which controls the withdrawal symptoms, does not end use due to the ongoing need for methadone
Suboxone® Is The Only
Option Currently Available
To Stop Withdrawal AND
Eliminate Opiate InfluenceMethadone Has Problems Because:
By virtue of its “maintenance” approach, methadone maintains some degree of opiate influence 24/7
Methadone frequently does not have an exit strategy because of ongoing maintenance
When tapered, there is a very high relapse rate
Suboxone® Fools The Brain
Into Acting Like The
Changes From Opiate Use
Have Totally HealedThe patient functions as if they never
used opiates
Opiate induced brain changes are stimulated to heal and revert to the pre-opiate state
As The Brain Heals, Less
Suboxone® Is Needed To
Insure Proper Function And
No Withdrawal SymptomsIt is the altered state of the brain that drives
opiate withdrawal
When the brain has totally recovered from
its opiate induced alterations, Suboxone® is
no longer needed because the withdrawal is
over
Dr. Russ’ Suboxone® RuleThe key to effective Suboxone® treatment
Insure that the Suboxone® blood level in the
patient is always at the lowest level necessary to
insure 100% elimination of withdrawal symptoms
24/7 until the opiate induced brain alterations
have 100% healed
This 100% guarantees proper functioning as
long as the individual does not ACTIVELY
CHOOSE to use opiates
Dr. Russ’ Suboxone® RuleUsing more Suboxone® than the minimum
needed causes problems:
Generates a mild opiate response than can
trigger relapse
Takes energy to fuel the opiate response that
could be used for healing
Inhibits healing because opiates appear to be
present, suggesting the need for the brain
alteration
Ideal Suboxone® Blood Level
Ideal Suboxone® Blood Level
Ideal Suboxone® Blood Level
Low Suboxone® Blood Level
There Is Life After Opiates!!
It Is Wonderful And
Available For Everyone
For More Information Please Go To
monmouthbehavioralmedicine.comClick “Resources” And Then “Addiction Medicine”
Email to [email protected]
Call 732-477-4470